Formal discussant of the patient-reported outcomes study by Smith et al presented at the Quality Care Symposium in Boston, Ethan Basch, MD, Director of the Cancer Outcomes Research Program at the University of North Carolina School of Medicine in Chapel Hill, praised the research for its important finding and message, but also said that it raised some questions.

“Quality programs have traditionally measured patients’ self-reported perceptions of care delivery rather than their self-reported symptoms. Previously, collection of patient-reported symptoms has largely been restricted to clinical trials. There are a few examples of quality programs that use these types of measures, but this new research suggests we should be doing this more often,” Dr. Basch said.

“Cancer patients are often symptomatic and their functioning is affected by the disease and its treatments. How do we assess this in the measurement of quality of care? Where? How often? And how do we minimize missing data? These are some of the important questions raised by this study,” he said.

‘Striking’ Results

“Results of this survey of 17 cancer centers were striking. When patients were asked whether they got the help they wanted, 42% to 60% said they did not, showing that this represents an unmet need,” Dr. Basch continued.

The study had several strengths, and results underline the importance of symptom management and show that patient-reported outcomes can provide valuable data for future interventions.

“One of the challenges of this research is that it is unclear whether symptom management was attempted and not perceived by the patient,” he emphasized. “The instrument may be particularly susceptive to patient-level variables. The study raises the question about whether an action was taken or whether patients perceived it was taken,” Dr. Basch said. ■

Disclosure: Dr. Basch reported no potential conflicts of interest.